A floppy baby with elevated right hemidiaphragm and large stomach bubble on chest radiograph: what’s the diagnosis?

A preterm neonate of 36 weeks’ gestation was born via emergency lower segment caesarean section, requiring respiratory support soon after birth. She was hypotonic from birth and was found to have a large gastric bubble and a raised right hemidiaphragm on X-ray. She reached full feeds through a nasogastric tube on day 3 of life but later developed severe gastro-oesophageal reflux with pulmonary aspiration. What is the likely diagnosis?

Fatimah Aliyu
ST6 Paediatric Trainee, York Teaching Hospital, NHS Foundation Trust, f.aliyu@nhs.net

Udoka Asoh
ST7 Paediatric Trainee, Neonatal Unit, Hull University Teaching Hospitals NHS Trust, u.asoh@nhs.net

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Keywords

very preterm; prematurity; neonatal; parent voice; family-integrated care (FiCare); NICU

Key points

Mothers of ‘healthy’ premature babies have very different psychosocial needs to mothers of poorly or critically ill babies.
There are many different facets of guilt that a mother on the NICU can experience.
Guilt can underpin a conflict of identity in mothers – the ‘theoretical mum’.
Good FiCare can enable mothers to identify and work through their feelings of guilt, supporting them to become ‘really mum’.

Also published in Infant:

VOLUME 16/ISSUE 2, MARCH 2020

Relieving paternal stress in the NICU

Parents often enter the neonatal intensive care environment unexpectedly with the early arrival of their infant and/or unforeseen illness. This can cause heightened stress and anxiety for both parents. When feeling these stressors parents, especially new fathers, may have difficulty bonding with their baby. Neonatal nurses are instrumental in providing care and bonding opportunities to new parents. This article focuses on the stress and anxiety of new fathers and addresses how healthcare staff can enhance the father-infant bond while decreasing the father’s stress.